Smoking and your skin

May 6, 2019 / Håvard Liltved Dalen
It’s not a myth: smoking affects your skin. The good news is, it’s partly reversible.
In short
  • Accelerates the natural aging process
  • Disrupts collagen and elastin maintenance
  • Accelerates sun damage

Smoker’s face is a thing

The ‘smoker’s face’ – is it really from smoking? The short answer is yes.

You know what it looks like. The face of a long-time smoker is prematurely wrinkly, a little gaunt and bony, grayish, and also a bit ruddy. Women get it worse than men do. It starts as a reduction in moisture level in the outermost layer of skin, which brings about a mild inflammatory reaction. Later, the skin gets thin, and fragile, and it tends to sag.

And it absolutely does come with tobacco exposure. We know from studying twins that there is a direct connection between the appearance of your skin and the number of packs of cigarettes you’ve smoked.

Why does it happen?

Cigarette smoke probably accelerates our skin’s normal aging process by forming ‘free radicals’, unstable molecules that go around destabilizing cells. That’s where the wrinkles come from. We’re not sure, but smoking may also interfere with normal cellular maintenance and repair as well.

We know it disrupts the manufacture and replacement of the connective tissue that holds your skin firm. These are collagen and elastin. If we took a tiny biopsy of affected skin, stained it, and put it under the microscope for you, you’d see the degradation there in ripply streaks of pink. It’s a process not unlike what happens in certain forms of sun damage.

Tobacco, by the way, accelerates sun damage, and sun damage accelerates tobacco-damage. Why is all this happening, down at the molecular level? We’re learning. Nicotine, we’re beginning to find, plays a strong role in actually modifying gene expression. And nicotine is only one constituent of tobacco smoke. There may be other molecules in smoke that do damage as well.

Can it be reversed?

If you stop smoking, there is no doubt that your skin will look better. Some of the damage will remain. But your skin will function more like it’s supposed to.

Restored blood-flow and movement of non-melanin pigment, says one recent study, will make your complexion better – and it’ll start improving right away.

You’ll say goodbye that smoker’s acne, too. And you’ll also be less likely to suffer the other dermatoses and disorders that smokers get more often than non-smokers do. That’s good by itself.

So there’s the lesson.

Smoker’s face is real. But if you don’t want it, you can stop it.

Our dermatologists answer questions about all skin conditions.